Research
and TrainingCenter

on
Independent Living at The University of Kansas

Progress Report #1: Methodology

January 17, 2005

Background

“Another
theme arising from 9/11 was the lack of empirical data on the safe and efficient
evacuation of persons with disabilities in disaster planning. This deficit in
the literature reflects a deeper chasm of emergency services departments that
are unprepared to assist people with physical disabilities during the
potentially devastating natural and technological disasters that regularly occur
in this nation. The scope of the problem and the potential impact on the welfare
of people with physical disabilities is significant.”

Investigators
at the Research and Training Center on Independent Living (RTC/IL) at the
University of Kansas, under the direction of Glen W. White, PhD, Principal
Investigator and Michael H. Fox, ScD, Co-Investigator, were awarded a three year
research grant funded by the Centers for Disease Control and Prevention through
the Association of Teachers of Preventive Medicine (TS#-0840).

Research Mission

The
mission of this research is to investigate a sample of 30 sites in the United
States where a federal disaster declaration was issued for natural or man-made
disasters in order to: (1) Determine if disaster plans and emergency response
systems include the needs of persons with mobility impairments; (2) Evaluate
surveillance systems that can identify the morbidity and mortality frequency and
prevalence of persons with mobility impairments in these disasters; and (3)
Identify Best Practices that meet the needs of persons with mobility impairments
in hopes of preventing injuries and saving lives.

Methodology

A federal disaster declaration
designation from FEMA is granted after a made-man or natural disaster reaches a
specific magnitude of destruction.Most
of the declarations are granted at the county level.Eight criteria were used as the sample selection scheme. The first and
second criterion required identifying and selecting the FEMA declared federal
disaster declarations from 1999 through 2002 for each of the 10 FEMA regions.
From this listing, researchers randomly selected one state level disaster from
each region. This process was repeated for each of the years. This resulted in
the selection of 40 state disasters, which represented the third criterion.

The
next step was to select a pool of sites from which the final sample would be
derived. To do this, the fourth criterion required each of the state level
disasters to include one or more sites in the sample. This involved randomly
selecting between 1-10 sites, depending on the number of sites affected by the
disaster.The number of sites
selected were as follows: For state
disaster occurrences in which < 5 sites were affected one site was
selected; for state disaster occurrences in which >5 and < 10 sites
were affected two sites were selected; for state disaster occurrences in which
>10 and < 15 sites were affected three sites were selected; for
16-20, four sites were selected; for 21-25 five sites where selected; and so on.Two samples were identified in this
manner, one with 140 and the other with 133 site disaster occurrences.These represented a pool of potential sites for our final sample that
were randomly representative of all regions within the United States.

The
fifth criterion required that sites be randomly selected into sets of 30 and
this process was repeated multiple times.This
was done to assure that replacement sites could be taken from randomly selected
sets of 30 to construct a final sample still representative of states within the
regions.The sixth criterion allowed
for other factors representing the selection criteria to be accounted for in
deciding upon the final sample.To
do this, the following information was merged for each of the 30 sites: disaster
type, site median income, population density as a proxy for urban/rural, access
to independent living services through a Center for Independent Living (CIL),
and ethnic/racial breakout.

The
seventh criterion called for site replacements to be made so that stratification
occurred with respect to anticipations in factors regarding regions, disaster
types, site median income, population density, access to CILs, and racial/ethnic
diversity.It was anticipated that
at least: (1) One federal disaster declaration occurrence is within each of the
regions; (2) 10% of the sites are man-made disasters; (3) 50% of the sites
represented areas above the national median income; (4) 15% of the sites are in
areas with a population density that is lower than 20 persons per square mile;
(5) 50% of the sites have access to a CILs, and (6) 50% of the sample had
non-white populations above the national average.

The sample met the factors for
regions, man-made disasters, and access to CILs. However, only 20% of the sites
were above the national median income, and more sites than anticipated were
rural.In addition, only 20% of the
sample had non-white populations above the medium income.Since the original sample did not meet the objectives for diversity and
urban/rural, additional sampling was performed. Our final percentages did
increase for some of the criteria, but were still somewhat below anticipated
figures for median income, population density, and racial/ethnic diversity.

To
satisfy the eighth criterion, multiple sites within each region that maintain
approximately the same strata were complied to be used as replacements.
Replacements for eight out of the original sample of 30 were required during the
course of the research study. In order to get the eight replacements, over 20
additional sites had to be selected and contacted. Once the interviews began a
few emergency managers wanted to redirect us to discuss a more recent declared
disaster or a similar disaster type that happened at a different date.This resulted in four disasters being studied from 2003, which is beyond
the original date ranges of 1998 to 2002 of the sampling formula.

The final sample of 30 sites met the same factors,
as did the previous sample, in the areas of regions, disaster types, and access
to CILs. The rural/urban distinctions improved slightly but were still above the
15% benchmark. The percentage for site median income and racial/ethnic diversity
again rose slightly, but were still considerably below anticipated percentages.

The
chart below depicts the site locations of the final sample by region and
disaster.

All ten FEMA regions were represented
with two or more disaster sites. This sample has a cross section of disaster
types represented.Twenty of the
sites were granted declarations to cover a single disaster, while ten of the
sites were granted declarations to cover multiple disaster types occurring for
the same time period.

In the study, there were 12 storms
labeled as “severe,” eight as flooding, five as a winter storm or snow
storm, three as a hurricane, three as a tropical storm, three as wildfires,
three as high winds or winds, two as resulting from a terrorist attack related
to 9/11, two as a freeze or freezing temperatures, and two as a tornado, and one
as an earthquake. Four sites reported that the incident itself had little impact
on them while two sites stated that it was the worst disaster to have occurred
in their memory.

Next steps in the research were to
develop a survey questionnaire, consent form, and obtain Institutional Review
Board (IRB) approval. The IRB approval allowed for oral consent from the
managers to be obtained.This also
assured approval of the survey language, and survey and consent procedures as
appropriate human subjects’ research tools.

A pilot study on six sites selected
from the original sample pool was conducted to test the survey questions and the
interview procedures. Minor revisions resulted.

The survey questions sought to get
information regarding: (1) the impact of the disaster; (2) content of the
emergency management plans; (3) any training in special needs populations; (4)
any data on the number of persons with mobility impairments; (5) what, if any,
guidelines or procedures exist to assist persons with mobility impairments, (6)
any plans in place to develop such guidelines or procedures, and (7) what
resources are needed to develop such guidelines or procedures.

Collection of emergency management plans proved
difficult, since we learned early on that the plan is a “living document,”
subject to constant revisions. Thirty directors of emergency management were
interviewed over the phone by the research staff with interviews lasting an hour
to two hours.Twenty emergency
managers initially declined to be interviewed with the primary reasons being
that (1) the disaster itself did not hit their area or (2) they were too busy to
take time to be interviewed. Preliminary results are forthcoming in another
progress report.

For
more information, contact Catherine “Cat” Rooney, project coordinator at